Sebelius Encourages Students with New Era of Health Care
Rand Corporation’s Robert Brook recently expounded on tools one can use to measure the success or failure of the new health care law – the Affordable Care Act. He mentioned mortality rates, hospitalizations, access to health care and the associated costs. However, Health and Human Services Secretary Kathleen Sebelius summed up the measures more succinctly in a speech to the American Medical Students Association’s annual convention earlier this month.
Whether she meant to or not, Sebelius submitted high expectations for the administration’s venture into government-run health care including promising a healthier population by focusing on prevention, suggesting primary care as the most rewarding practice in the future, and saying the new health care law will significantly reduce readmissions into hospitals.
Concerning the future, Sebelius said, “You are entering medicine at a time of historic change. The combination of a wave of health innovation of a wave of health innovation across the country and the most important health legislation in over forty years has created a unique opportunity for progress in health care.”
The legislation Sebelius refers to, of course, is the Affordable Care Act, an unprecedented attempt by the federal government to bring order to an enormous segment of the nation’s economy. The administration is clearly relying upon prevention to curtail rising costs in the health sector and Sebelius emphasized that in her medical students association address.
“. . . there will be a new national focus on prevention, both inside and outside the doctor’s office,” Sebelius said. “There is a growing body of evidence that people’s behaviors outside the health care system – what we eat, how much we exercise, whether we smoke or not – affect our health just as much, if not more, than the treatments and medicines we get when we visit a doctor.”
Left unsaid by Sebelius is the extent to which health care administrators will need to delve into the details of Americans’ lives. Governing dietary habits, exercise regimens, and bad habits makes sense on paper, but implementing that level of scrutiny of daily life may prove impossible. In an attempt to meet that challenge, Sebelius told her audience her agency is now funding local programs to reduce chronic disease, establishing new laws to improve school lunches, and clamping down on the ability of tobacco companies to market their products.
In the arena of health care providers, the administration is on a mission to convince aspiring medical students to choose primary care in greater numbers. Primary care’s appeal and reputation has been in decline for years as specialty care’s attractiveness has risen in the eyes of medical students and patients alike.
Again, Sebelius emphasized what the federal government will do to shift those trends. “The health care system of the future will also have a greater focus on primary care. I want you to raise your hand if you’re thinking about going into primary care. Now, raise your hand if you’d consider primary care if there was a smaller pay gap between pediatricians and specialists.” She continued, “Primary care is too important to be treated as if it was of secondary importance. That’s why through the Affordable Care Act, we’re increasing reimbursement rates for primary care. And we’ve added thousands of slots to National Health Service Corps, a Peace Corps for health workers. If you go and practice care in an underserved community, we’ll help you repay your loans – a win/win.”
A win/win for the patient perhaps, but a question mark regarding the federal government’s ability to fulfill those kinds of financial commitments. A recent update of the cost of the Affordable Care Act during the next decade by the Congressional Budget Office revised estimates from more than $900 billion to almost double that - $1.7 trillion.
Sebelius completed her speech by reminding medical students that while they face significant challenges in the years ahead, they need to remind focused on a brighter future for health care in the United States. “If we can seize the opportunity in front of us, I believe you can be the generation of doctors that helps us usher in a new day for health care in America.”